CyberKnife Robotic Stereotactic Radiosurgery

Pollom, Erqi L.; Wang, Lei; Gibbs, Iris C.; Soltys, Scott G.

doi:10.1007/978-3-030-16924-4_6

Cited by 7 publications

(8 citation statements)

References 53 publications

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“…The third limitation of our study was that the CK M6 system was unavailable for this dosimetric comparison. The new generation of the CK M6 system using MLC has been shown to improve the treatment plan quality 52 based on the G4 accuracy 48 . The CK-MLC plans generated for the SRS treatment delivered a more homogeneous dose to the target than the cone-based CK plans, providing equivalent coverage, conformity, and OAR doses with the potential to improve treatment quality—for example, by achieving a better dose gradient in the low-dose region 53 – 55 .…”

Section: Discussionmentioning

confidence: 99%

“…The median treatment time per fraction in the fifteen enrolled patients treated with CK was 75 min. Although the delivery time of the new CK (VSI and M6) system has been improved (25–30 min per fraction) 52 , owing to the step-and-shoot method and the travel time of the robot between delivery nodes, treatment efficiency may still be a drawback compared to the continuous arc delivery provided Linac-based systems 52 . Moreover, one of the novel features of HA is automated delivery workflow; in general, the average time spent on HA treatment of the first forty patients at our institution is 13.23 min, which is very close to the time slot (10 min) allotted for conventional fractionation in our institution.…”

Section: Discussionmentioning

confidence: 99%

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The new SRS/FSRT technique HyperArc for benign brain lesions: a dosimetric analysis

Yang

Lin

et al. 2021

Sci Rep

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To evaluate the potential benefit of HyperArc (HA) fractionated stereotactic radiotherapy (FSRT) for the benign brain lesion. Sixteen patients with a single deep-seated, centrally located benign brain lesion treated by CyberKnife (CK, G4 cone-based model) were enrolled. Treatment plans for HA with two different optimization algorithms (SRS NTO and ALDO) and coplanar RapidArc (RA) were generated for each patient to meet the corresponding treatment plan criteria. These four FSRT treatment plans were divided into two groups—the homogeneous delivery group (HA-SRS NTO and coplanar RA) and the inhomogeneous delivery group (HA-ALDO and cone-based CK)—to compare for dosimetric outcomes. For homogeneous delivery, the brain V5, V12, and V24 and the mean brainstem dose were significantly lower with the HA-SRS NTO plans than with the coplanar RA plans. The conformity index, high and intermediate dose spillage, and gradient radius were significantly better with the HA-SRS NTO plans than with the coplanar RA plans. For inhomogeneous delivery, the HA-ALDO exhibited superior PTV coverage levels to the cone-based CK plans. Almost all the doses delivered to organs at risk and dose distribution metrics were significantly better with the HA-ALDO plans than with the cone-based CK plans. Good dosimetric distribution makes HA an attractive FSRT technique for the treatment of benign brain lesions.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The new SRS/FSRT technique HyperArc for benign brain lesions: a dosimetric analysis

Yang

Lin

et al. 2021

Sci Rep

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“…The CyberKnife VSI‐System (Accuray, Sunnyvale, CA, USA) (Figure 1), where VSI stands for versatile, simple, and intelligent, is an advanced radiotherapy device for stereotactic radiosurgery (SRS) and stereotactic body radiotherapy (SBRT) 4 and was developed by John R. Adler 5 . It consists of the following components 6 : the linear accelerator (LINAC), which is flanged to an industrial robot manufactured by KUKA (Augsburg, Germany), the treatment table, also called RoboCouch, two x‐ray tubes (VAREX Imaging, Salt Lake City, Utah, USA) with two Flat Panel Detectors (Perkin Elmer, Waltham, Massachusetts, USA) facing each other for orthogonal verification images for patient alignment, a collimator table, also called XChange table, with 12 different circular collimators and an IRIS‐aperture, 7 and a camera system for breath‐triggered irradiation …”

Section: Introductionmentioning

confidence: 99%

“…3 The CyberKnife VSI-System (Accuray, Sunnyvale, CA, USA) (Figure 1), where VSI stands for versatile, simple, and intelligent, is an advanced radiotherapy device for stereotactic radiosurgery (SRS) and stereotactic body radiotherapy (SBRT) 4 and was developed by John R. Adler. 5 It consists of the following components 6 :…”

Section: Introductionmentioning

confidence: 99%

Development of a LINAC head model for the CyberKnife VSI‐System using EGSnrc Monte Carlo system

Thiele,

Galonske,

Ernst

et al. 2023

J Applied Clin Med Phys

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IntroductionIn order to understand the interaction processes of photons and electrons of the CyberKnife VSI‐System, a modeling of the LINAC head must take place. Here, a Monte‐Carlo simulation can help. By comparing the measured data with the simulation data, the agreement can be checked.Materials and methodsFor the Monte‐Carlo simulations, the toolkit EGSnrc with the user codes BEAMnrc and DOSXZYnrc was used. The CyberKnife VSI‐System has two collimation systems to define the field size of the beam. On the one hand, it has 12 circular collimators and, on the other, an IRIS‐aperture. The average energy, final source width, dose profiles, and output factors in a voxel‐based water phantom were determined and compared to the measured data.ResultsThe average kinetic energy of the electron beam for the CyberKnife VSI LINAC head is 6.9 MeV, with a final source width of 0.25 cm in x‐direction and 0.23 cm in y‐direction. All simulated dose profiles for both collimation systems were able to achieve a global gamma criterion of 1%/1 mm to the measured data. For the output factors, the deviation from simulated to measured data is < 1% from a field size of 12.5 mm for the circular collimators and from a field size of 10 mm for the IRIS‐aperture.ConclusionThe beam characteristics of the CyberKnife VSI LINAC head could be exactly simulated with Monte‐Carlo simulation. Thus, in the future, this model can be used as a basis for electronic patient‐specific QA or to determine scattering processes of the LINAC head.

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“…The CyberKnife®, which was developed by John Adler, 1 is a dedicated robotic system for carrying out stereotactic radiosurgery (SRS) and stereotactic body radiotherapy (SBRT) 2 . Beams can be collimated using the IRIS™‐aperture, 3 fixed cones, or InCise™ multileaf collimator (MLC) 4 .…”

Section: Introductionmentioning

confidence: 99%

Comparison of two optimization algorithms (VOLO^TM, SEQU) for CyberKnife® treatment of acoustic neuromas, lung metastases, and liver metastases

Thiele,

Galonske,

Ernst

2023

J Applied Clin Med Phys

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IntroductionTwo optimization algorithms VOLO™ and sequential optimization algorithm (SEQU) are compared in the Precision® treatment planning system from Accuray® for stereotactic radiosurgery and stereotactic body radiotherapy (SBRT) treatment plans. The aim is to compare the two algorithms to assess if VOLO™ is better of SEQU in certain treatment site.Materials and MethodsSixty clinical treatment cases were compared. Entities include Acoustic neuroma (AN), lung metastases, and liver metastases. In each entity, 10 SEQU and 10 VOLO™ treatment plans were optimized. The Ray‐Tracing calculation algorithm was used for all treatment plans and the treatments were planned exclusively with fixed cones (5–50 mm). The number of nodes, beams, total MU, and treatment time were compared. Conformity index (CI), new conformity index (nCI), homogeneity index (HI), gradient index (GI), and target coverage were examined for agreement. Dmin, Dmean, Dmax, D100%, D98%, and D2% dose in the target volume as well as exposure to organs at risk was checked. To determine peripheral doses, the isodose volumes from V10% to V98% were evaluated.ResultsAN treatment plans showed significant differences for the number of nodes, beams, total MU, treatment time, D98%, D100% for the target volume, and the doses for all organs at risk. VOLO™ achieved better results on average. Total MU, treatment time, coverage, and D98% are significantly better for VOLO™ for lung metastases. For liver metastases, a significant reduction in number of nodes, total MU, and treatment time was observed for VOLO™ plans. The mean target coverage increased slightly with VOLO™, while the mean CI deteriorated slightly. The averages of Dmin, Dmean, D98%, D100%, and V80% resulted in a significant increase for VOLO™.ConclusionThe results of the present study indicate that VOLO™ should be used in place of SEQU as a standard for AN cases moving forward. Despite the lack of significance in the lung and liver cases, VOLO™ optimization is recommended because OAR sparing was similar, but coverage, Dmin, and Dmean were increased, and thus better tumor control can be expected.

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CyberKnife Robotic Stereotactic Radiosurgery

Cited by 7 publications

References 53 publications

The new SRS/FSRT technique HyperArc for benign brain lesions: a dosimetric analysis

The new SRS/FSRT technique HyperArc for benign brain lesions: a dosimetric analysis

Development of a LINAC head model for the CyberKnife VSI‐System using EGSnrc Monte Carlo system

Comparison of two optimization algorithms (VOLO^TM, SEQU) for CyberKnife® treatment of acoustic neuromas, lung metastases, and liver metastases

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CyberKnife Robotic Stereotactic Radiosurgery

Cited by 7 publications

References 53 publications

The new SRS/FSRT technique HyperArc for benign brain lesions: a dosimetric analysis

The new SRS/FSRT technique HyperArc for benign brain lesions: a dosimetric analysis

Development of a LINAC head model for the CyberKnife VSI‐System using EGSnrc Monte Carlo system

Comparison of two optimization algorithms (VOLOTM, SEQU) for CyberKnife® treatment of acoustic neuromas, lung metastases, and liver metastases

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Comparison of two optimization algorithms (VOLO^TM, SEQU) for CyberKnife® treatment of acoustic neuromas, lung metastases, and liver metastases